ENDOCRINE Flashcards
For Hypothyroidism think _________?
Hypermetabolism
What are the S and S of Hypermetabolic
- Weightloss
- Skinny
- > BP
- > Pulse
- Personality, irritable, Hyper, obnoxious, excitable.
- Heat Intolerance
- Cold Tolerence
- Exopthalmos
What is the other name for Graves Disease?
Hyperthyroidism
“ Run ourself into the ground”
What are the 3 treatment options for Graves Disease.
- Radio Active Iodine
- Pt. should be alone 24hrs
- Flush urine x 3
- Hasmat team for split urine
- Radio Active Excretes through urine.
2. PTU - Med given for hyper thyroid
Puts
Thyroid
Under
*puts thyroid under < WBC
- Primary use is cancer
- Also used for hyperthyroid
- immonosuppression monitor WBC
- Surgery - Thyroidectomy
- Total Thyroidectomy
- Subtotal Thyroidectomy
Describe a Total Thyroidectomy?
- Removal of Thyroid
- Life long hormone replacement
At risk for low calcium!
Calcium does opposite, so with hypocalcemia everything will go up! tetany, spasm, seizure irritablilty etc.
1st sign of Hypocalcemia = Parathesia
What 2 signs indicate Hypocalcemia?
- Trousseau’s Sign - Latent tetany carpel spasm occurs when the upper arm is compressed with a tourniquet of BP cuff.
- Chovsteks Sign - Twitching of facial muscles in response to tapping over the area of the facial nerve.
Describe a Sub Total Thyroidectomy
Hormone replacement for short term ….
At risk for thyroid storm, thyroid crisis.
- High temp >105
- Extremely high BP 210/180
- Severe tachycardia
- Psychotic delirum
- This is a medical emergency causes brain damage must tx. immediately by < temp and > O2
SUB = Storm. Total=Tetany
How does the nurse TX. a high temp caused from thyroid storm?
Ice packs (FIRST) Cooling blanket (BEST) O2 per mask - 10 L Once T3 or T4 gets out of system - better No medication - just sparing the brain 2:1 staff pt. ratio
Good Nursing Care will save their life.
Stay with Pt.
Post Op Risks for Thyroidectomy
- First 12 hrs doesn’t matter if its total or subtotal top priority is always AIRWAY!
- Hemorrhage
- 12-48hrs - this is where you must pay attention to if its a total of sub total.
- Total = Tetany b/c low calcium
- Sub = Thyroid Storm
"Totals get Tetany" "Subs get Storm" 12-24 hrs after surgery!
Never pick infection prior to less than _____ hrs.
72
Describe the characteristics of HYPOTHYROIDISM (Myxedema)
Think Hypometabloism
- Obese
- Flat, boring, dull
- Cold intolerance
- Heat intolerance
- Low pulse
- BP Low
- Slow test taker
- AKA Myxedema
- Not enough hormone
- Synthyroid
- Caution do not sedate
- Question any sleeping pill order
- Do not hold thyroid pills unless you were told and even then double check!
All Diseases that affect the adrenal cortex start with the letter “ A “ or “ “C”. Give 3 examples
- Addison’s Disease
- Cushings Syndrome
3 Acute Exacerbation or COPD
Describe Addison’s Disease
- Under Secretion of Adrenal Cortex
- Hyper-pigmented very tanned
- Do not adapt to stress b/c adrenal glands under secreting, so if they under go any stress their stress response does not kick in therefore they experience opposite effects < glucose < BP and and will therefore go into shock, it takes them no time at all to go into shock.
How do we treat Addisons Disease?
Steroids Glucocorticoids
“SONES”
“ In ADDISONS you “ADD-A-SONE”
Describe Cushings Syndrome
Over Secretion of Adrenal Cortex
“CUSHY TUSHY”
Think Cush Man
- Atrophy of extremities
- Bruise easily
- Buffalo Hump
- Gynecomastia -boobies
- Heresutism - excess hair
- High glucose
- Hypertension
- Immunosuppressed - infection
- irritable
- Muscle weakness
- Puffy moon face
- Osteoporosis
- Retains sodium and water therefore loses potassium
- Striae
- Trunkle or Central Obesity
